Global Civil Society Letter to the Inter-Agency Expert Group on SDG Indicators: In relation to target 3.8 to achieve Universal Health Coverage

PDF File: Global Civil Society Letter to the Inter-Agency Expert Group on SDG Indicators_Target 3.8 Universal Health Coverage_23 July

Global Civil Society Letter to the Inter-Agency Expert Group on SDG Indicators: In relation to target 3.8 to achieve Universal Health Coverage 

Courtesy of:
United Nations Statistical Division,
UN Department of Economic and Social Affairs,
United Nations Headquarters,
New York 10017, United States

23 July 2015

Dear Members of the Inter-Agency and Expert Group on SDG Indicators,

We write in response to the list of proposed priority indicators for the post-2015 development agenda dated 7 July 2015, and specifically in relation to target 3.8: “Achieve Universal Health Coverage, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”.

Current proposals suggest two priority indicators for target 3.8, one of service coverage and the other on financial risk protection:

1. Coverage of tracer interventions (to be collected via household surveys and facility data);
2. Fraction of the population protected against catastrophic/impoverishing out-of-pocket health expenditure (to be collected via household surveys).

We are pleased to see both aspects of Universal Health Coverage (UHC) reflected in the new proposal and strongly encourage you to ensure both indicators are kept within the framework. UHC means all people receiving the quality health services they need, without being exposed to financial hardship. Based on this definition, UHC has two inherent and linked concepts that must be considered together: universal service coverage and universal financial protection. Effective tracking of both components will be vital to the realisation of UHC and the SDGs. Omitting a measure of financial risk protection would be a failure to address the impoverishing effect of health spending on some of the poorest and most marginalised groups and, as such, a neglect of equity considerations.

While we welcome your efforts to streamline indicators in the framework, there is consensus in the health community that target 3.8 must be tracked using these two indicators. Without consideration of both, policy and decision-makers can neither adequately assess progress nor set appropriate policy. Neglecting one of these fundamental aspects of UHC renders the target redundant: UHC is about equality in access to affordable healthcare and measuring by one indicator alone would miss this fundamental point. Moreover, in most countries credible comparable data on both of these measures is already collected and the inclusion of both indicators would not produce an additional reporting burden.

We would be very pleased to have a more detailed discussion with you about this.

Yours sincerely,

Signed by the following organisations:



1. ABSAM Health Research Centre, Turkey
2. Action For Global Health, International
3. Action Group For Health, Human Rights And HIV/AIDS (AGHA), Uganda
4. Action Medeor E.V., Germany
5. ADRA Germany E.V., Germany
6. Africa Cancer Foundation, Kenya
7. Alliance Of Young Nurse Leaders And Advocates International, Inc., Philippines
8. American Heart Association, United States
9. Amref Health Africa, Kenya
10. Anesvad, Spain
11. APOPO, Tanzania
12. Aravind Eye Care System, India
13. AS Center For The Empowerment Youth Of People Who Are Living With HIV And AIDS, Serbia
14. Asian Forum Of Parliamentarians On Population And Development, International / Thailand
15. Asociación Latinoamericana de Organizaciones de Promoción al Desarrollo A.C.,
16. Bethel Viva Foundation, Nigeria
17. BHORE, Nepal
18. Blood Patients’ Protection Council (BPPC), India
19. BRAC, International / Bangladesh
20. Bread For The World, Germany
21. Cancer Warriors Foundation, Philippines
22. Centre For Health Information, Policy & Systems Research (CHIPSR), Fiji
23. Centre For Sustainable Development And Education In Africa, Nigeria
24. Centre Of Excellence For Universal Health Coverage, BRAC University, Bangladesh
25. Childhood Cancer International, International / Netherlands
26. Children’s HeartLink, United States
27. CIMSA (Center For Indonesian Medical Students’ Activities), Indonesia
28. Community Working Group On Health (CWGH), Zimbabwe
29. DSW (Deutsche Stftung Weltbevoelkerung), Germany
30. Fast Rural Development Program – FRDP, Pakistan
31. Federación De Planificación Familiar Estatal, Spain
32. Forum For Human Rights And Public Health-Nepal (Friendship-Nepal), Nepal
33. Global Health International Advisors (GHIA), United States
34. Global Poverty Project, United States
35. GlobeMed at Emory University, United States
36. Help Me See, United States
37. IFMSA-Kurdistan, Kurdistan Region Of Iraq
38. Individual – Dr Janet Downs, New Zealand
39. Individual – Obstetrician And Gynaecologist, Central Hospital, Warri, Delta State, Nigeria
40. Kingsley Agholor, Nigeria
41. International Agency For The Prevention Of Blindness (IAPB), International / UK
42. International Campaign For Women’s Right To Safe Abortion, International
43. International Children’s Palliative Care Network, South Africa
44. International Council For Education Of People With Visual Impairment, United Kingdom
45. International Council Of Ophthalmology, Switzerland
46. International Eye Foundation,United States
47. International Federation Of Medical Students’ Associations (IFMSA), International
48. International HIV/AIDS Alliance, United Kingdom
49. International NGO Forum On Indonesian Development-INFID, Indonesia
50. International Planned Parenthood Federation, International
51. International Women’s Year Liaison Group, Japan
52. Irish Family Planning Association, Ireland
53. Ispahani Islamia Eye Institute And Hospital (IIEI&H), Bangladesh
54. Israel Cancer Association, Israel
55. Italian Association for Women in Development (AIDOS), Italy
56. Jordan Paramedic Society (JPS ), Jordan
57. Latino Commission On AIDS, USA
58. London School Of Hygiene And Tropical Medicine, United Kingdom
59. Malaria Consortium, United Kingdom
60. Malaysian AIDS Council, Malaysia
61. Management Sciences for Health, United States
62. Marie Stopes International, International / UK
63. Maternity Worldwide, United Kingdom
64. National Empowerment Network Of People Living With HIV/AIDS In Kenya, Kenya
65. NCD Alliance, Switzerland
66. Nigeria Network of NGOS, Nigeria
67. Norwegian Association Of The Blind And Partially Sighted (NABP), Norway
68. One Million Community Health Workers Campaign, United States
69. OPC – Organisation pour la Prevention de la Cecite, France
70. Operation Eyesight Universal, Canada
71. Operation Hope (CBO), Kenya
72. Operation USA, United States
73. Organisation pour la Prevention de la Cecite, France
74. Oxfam, International/United Kingdom
75. Plan UK, United Kingdon
76. Positive-Generation, Cameroon
77. Poulation Matters, United Kingdom
78. Prevent Blindness, United States
79. Project Muso, Mali
80. Red Por Los Derechos Humanos De Niños, Niñas Y Adolescentes (REDHNNA), Venezuela
81. Resource Centre for Primary Health Care (RECPHEC), Nepal
82. RESULTS UK, United Kingdom
83. ROOTS, Zimbabwe
84. Save The Children UK, United Kingdom
85. Sightsavers, United Kingdom
86. SNEHA (Society For Nutrition Education And Health Action), India
87. Sociedad Española De Salud Pública Y Administración Sanitaria (SESPAS), Spain
88. Sociedad Latinoamericana Y Del Caribe De Oncología Médica, Argentina
89. Terre Des Hommes Germany, Germany
90. The Fred Hollows Foundation, Australia
91. The Institute For Health Policy And Systems Research (IHPSR), Hong Kong SAR
92. THET, United Kingdon
93. Treatment Access Watch, Cameroon
94. UNISON, United Kingdom
95. Universidad Isalud, Argentina
96. Vision 2020 Australia, Australia
97. Vision For A Nation Foundation, United Kingdom
98. Volunteers-RH, Cameroon
99. Wateraid, United Kingdom
100. Women’s Hope Association, Burundi
101. World Heart Federation, Switzerland
102. World YWCA, Switzerland
103. Wote Youth Development Projects, Kenya
104. Zambia Asthma Association, Zambia
105. Zambia Heart And Stroke Foundation, Zambia


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